ZD4-24913-62417

3 vaccinations 7 coded responses 19 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 761 / TX
Registered: 2021-01-21

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Possible VAERS report

VAERS ID	Confidence	Score	Runner-up	Shared symptoms	Dose	State	VAERS vaccinated / onset / received	Call case
2105695 (opens in a new window)	high	11 / 11	1	1 of 2 VAERS symptoms	same dose (3)	TX matches	2021-10-23 / 2022-01-03 / 2022-02-11 received the same day as the last call	case 102926

From the VAERS matching of call center cases (loader/vaers_match_*). Only the best match is shown, and only if it scores 8 or more out of 11. The score adds up timing (VAERS received soon after the call center contact), dose and shared symptoms; state only breaks ties. Confidence is high when the score is 8+ and at least 3 points ahead of the runner-up, medium when 5+ and 2 ahead, otherwise low. A match is a likely link, not a confirmed one.

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-27
Dose 1 — Moderna
2021-01-21
Registered in v-safe
2021-01-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-24
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-25
Dose 2 — Moderna
2021-01-25
Survey response — day 0, dose 2
MedDRA: Feeling jittery, Hyperhidrosis, Neck pain, Pre-existing disease, Tremor, Vision blurred — Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Abdominal pain

Free text: Sharp pain in my neck on right side , sweating prespiration in face, jittery inside my body, shaking, vision blurred I have eye blindness diease kertaconeous

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Abdominal pain · Be unable to work

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye, Eye irritation, Eye pruritus — Feeling: Poor · Site: Pain, Itching · Chills, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Itchy eye burning dry eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — day 14, dose 2
MedDRA: Cough, Diarrhoea, Headache, Oropharyngeal pain — Feeling: Poor · Be unable to work

Free text: Headache coughing diarrhea sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-03
Survey response — day 35, dose 2
MedDRA: Headache, Muscle spasms, Tendonitis, Vomiting — Feeling: Poor · Be unable to work

Free text: Vomiting, neck tendinitis, severe headached, joint spasms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 42, dose 2
MedDRA: Ear pain, Headache — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Headache and a earache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-15
Call 1 — Left Voicemail
2022-01-24
Survey response — 3 months, dose 3
MedDRA: COVID-19, Medical counselling, SARS-CoV-2 test — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: I got Covid on 1/5/22. After been fully vaccinated with my booster shot. And I also had my flu shot. · Healthcare visit (other): Covid test at a Covid testing site

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-11
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-27	Moderna
2	2021-01-25	Moderna
3	2021-10-23	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-11	Successful	Does not wish to fill out VAERS report
2022-01-24	Successful 2022-02-11	Completed over the phone

Free text

Release 2 — day 0, dose 2

2021-01-25

Systemic reaction (other): Sharp pain in my neck on right side , sweating prespiration in face, jittery inside my body, shaking, vision blurred I have eye blindness diease kertaconeous

Release 2 — days 1–6 daily, dose 2

2021-01-27

Systemic reaction (other): Coughing

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Itchy eye burning dry eyes

Release 3 — day 14, dose 2

2021-02-08

Symptoms: Headache coughing diarrhea sore throat

Release 4 — day 35, dose 2

2021-03-03

Symptoms: Vomiting, neck tendinitis, severe headached, joint spasms.

Release 5 — day 42, dose 2

2021-03-11

Symptoms: Headache and a earache

Release 11 — 3 months, dose 3

2022-01-24

Symptoms: I got Covid on 1/5/22. After been fully vaccinated with my booster shot. And I also had my flu shot.

Healthcare visit (other): Covid test at a Covid testing site

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Medical counselling	·	·	✓
HCVO	SARS-CoV-2 test	·	·	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Tendonitis	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Feeling jittery	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Tremor	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release